Objective To apply doctor-patient communication model to improve students doctor-patient communication, and to raise medical quality. Methods 200 patients were allocated to observation group and control group randomly. In the observation group, we applied doctor-patient communication model,the other with common education schema. In order to appraise clinic effect,60 students were allocated to observation group and control group randomly. We applied doctor-patient communication model based on common medical education to the observation group, the other with common medical education. Results Patients in treatment group had more apparent clinic effect than control group.Students in treatment group. had more apparent capability than control group. Conclusion Application of doctor-patient communication in department of Neurology can improve stu-dents'clinic study and improve their clinic quality,and it can also completely cultivate the ability .of new type of medical talents.

Aim To study the combined effect Euphor-bia kansui of and Glycyrrhiza uralensis on metabolism of Kansuinine A and Kansuinine B. Methods Control, GU and GU plus EK groups were treated for 10 days, respectively. Then the liver microsomes were pre-pared. KA and KB were incubated with microsomes of each group, and concentrations of KA and KB were measured to reflect the metablism of KA and KB. E-rythromycin, diphenhydramine hydrochloride,benzbro-marone, cimetidine, fluconazole the inhibitors of CYP3 A4 , CYP2 D6 , CYP2 C9 , CYP1 A2 , CYP2 C19 respectively, were incubated with KA and KB. Con-centrations of KA and KB were measured to reveal the cytochrome P450 isoforms which involved in the metab-olism of them. KA and KB were incubated with glycyr-rhizic acid and enoxolone. Then concentrations of KA and KB were measured to reveal the effects of glycyr-rhizic acid and enoxolone to KA and KB. Results Concentrations of KA and KB in GU plus EK group were significantly higher than those in control and EK groups, which showed that the metablisom of KA and KB was inhibited in GU plus EK group. In addition, concentrations of KA and KB were higher in microsomes incubated with erythromycin, diphenhydramine hydrochloride, benzbromarone, cimetidine and fluconazole than in control group, which revealed that the metablism of KA and KB was slowed down when CYP3A4, CYP2D6, CYP2C9, CYP1A2 and CYP2C19 were inhibited. They may participate in the metablisom of KA and KB. After incubation with glycyrrhizic acid and enoxolone, the metablism of KA and KB was slowed down. Conclusions KA and KB may be the substrates of CYP2C19. GU plus EK can inhibit the activity of CYP2C19, which resulted in KA and KB metablism slowing down and accumulation. In addition, glycyrrhizic acid and enoxolone can inhibit the metablism of KA and KB. It may be one of the reasons of increased toxicity of GU plus EK.

Objective To discuss the relationship between various T lymphocyte subsets apoptosis and disease progression in chronic antiretroviral-naive HIV/AIDS patients. Methods Thirty-six chronic antiretrovi-ral-naive HIV-infected individuals as well as 16 healthy HIV-negative controls were performed in this study. Ac-cording to the CD4~+ T cell counts, all the patients were divided three groups: < 200/μl, 200-350/μl and > 350/μl. After the peripheral blood mononuclear cells(PBMC) were isolated, T lymphocyte subpopulations were determined by the expression of CD45RO and CD27, and the apoptosis of different T cell subsets were measured by Annexin V staining, then analyzed by flow cytometry. To investigate whether the apoptosis of T cells varied with the culture time in vitro, 4 healthy controls and 4 patients were chosen as subjects, and the lev-els of cell apoptosis were analyzed at the culture time points of 0, 3, 6, 12, 24 h. Results (1)The percenta-ges of the AnnexinV expression on CD4~+ and CD8~+ T cells and all the subsets in HIV/AIDS patients were sig-nificantly higher than that in the healthy controls (P<0.05), but there were no significant differences among the three HIV-infected patient groups(P>0.05). (2) No significant correlations were observed between the levels of apoptosis of all the T cells and subsets and total CD4~+ T cell counts(P>0.05) ,nor with the HIV viral load (P>0.05). (3)As the culture time prolonged in vitro, the levels of apoptosis and necrosis of CD4~6 T cells in HIV/AIDS patients were significantly higher than those in the healthy conlrols, and the CD4~+ T cells were more susceptible to apoptosis and necrosis compared with CD8~+ T cells. Conclusion The levels of T cell apoptosis in HIV/AIDS patients was significantly higher than those in the healthy controls, at the same time, CD4~+ T cells were more susceptible to apoptosis and necrosis compared with CD8~+ T cells, but no correlation was found between the T cell apoptsis and disease progression.

Objective To explore the values of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)measurements in various lesions of multiple sclerosis(MS).Methods Sixty patients with clinically diagnosed remitting-relapsing MS(RRMS)were included to undergo conventional brain MRI and DWI scans.the lesions were included when the diameter was more than 5 mm.mean ADC values were measured for various lesions of MS.The statistical analyses were performed to determine the differences of mean ADC values among various lesions of MS.and to compare the correlation between ADC values of lesions and Expanded Disability Status Scale(EDSS)scores.Results (1)The ADC value of hypointense lesions was significantly higher than that of isointense lesions(F=55.90,P<0.05),the ADC values were(127.5 ±9.3)×10-5mm2/s and(95.7 ±6.3)×10-5mm/s respectively.The nodular enhancing lesions had a significantly lower ADC value than the ring-enhancing lesions(F=64.18,P<0.01).the ADC values were(114.7 ±12.3)×10-5mm2/s and(140.7 ±11.0)×10-5mm2/s respectively.The ADC value of confluent lesions was substantially higher that of discrete lesions(t=9.04,P<0.01).the ADC values were(141.4±6.5)×10-5mm2/s and(105.4±13.9)×10-5mm2/s respectively.(2)No correlation between ADC of lesions and EDSS scores was found(r=0.35,P>0.05).Conclusion DWI and quantitative ADC are useful to explain the pathological changes in different lesions and to monitor the disease duration of MS.

Objective To investigate the brain magnetic resonance imaging(MRI)findings in 33 patients with neuromyelitis optica(NMO).Methods Patients who fulfilled the latest diagnostic criteria of NMO and whose brain MRI did not satisfied with diagnostic criteria of multiple sclerosis(MS)were enrolled.All the patients underwent brain MRI and spinal cord scannings and subsequent images analysis.Results Thirty-three patients with NMO were included to study.Five out of 33(15.2%)patients did not have brain parenchymal abnormalities,28 out of 33 patients(84.8%)were detected to have brain abnormal findings.Brain parenchymal lesions were well-defined in 22 patients(66.7%),no non-specific or atypical brain parenchymal lesions were found in the supratentorium or infratentorium in the other 6 cases(18.2%).However,brain MRI disclosed macroscopic,symmetrical diffuse FLAIR and T2-visible hyperintensity in deep white matter.Fifteen cases had more than one lesion(≥2 lesions),and the other 7 cases had single lesion.Supratentorial lesions were mostly punctate or small dots in nonspecific hyperintensity in juxtacortical,subcortical and deep white matter regions,a few were atypical patches.In the infratentorium,brainstem was an easily involved region(14/33,42.4%),especially in medulla(7/33,21.2%).Conclusions Brain MRI abnormalities are common in Chinese NMO,and brain lesions do not exclude the diagnosis of NMO.The observations of brain lesions are helpful to improve and revise diagnostic criteria of NMO.

Object To observe the protective effect of total isoflavones of pueraria DC (TIP) on osteoporosis induced by estrogen deficient rat Methods 42 10 month old female SD rats were bilaterally ovariectomized and 10 animals were made sham operation (Sham) under anesthesia. After 7 d, the ovariectomized rats were divided into 4 groups: untreated control (OVX) group (n=12); 2 treated groups (n= 10 each), one with 100 mg/kg TIP ig and the other with 20 mg/kg TIP ig, and a niylestrol group (E 3) (n= 10) The total body bone mineral content (BMC), and bone mineral density (BMD) and bone biodynamics were detected at 4th and 7th month Results 1 Compared with OVX group, BMC and BMD in TIP 100 mg/kg group were increased by 14 6% and 12.1% at 4th month, by 6 8% and 14 2% at 7th month, while in TIP 20 mg/kg group by 7 8% and 6 9% at 4th month, by 8 6% and 14 9% at 7th month 2 The densities of femur in TIP 100 and 20 mg/kg groups were respectively increased by 3 8% and 3 4%, while those of tibia by 6 8% and 6 3% than that of OVX control group The Ca contents were increased by more than 15% in the TIP treated groups 3 The maximum load and structural strength of femur were increased by 16 1% and 19 4% in TIP 100 mg/kg group and 9 1% and 12 5% in TIP 20 mg/kg group than OVX control group These parameters in tibia were also improved 4 Uterine weights both in TIP 100 and 20 mg/kg groups were almost increased by one fold than OVX group Conclusion TIP can protect osteoporosis induced by ovariectomized rats and these effect may be attributable to its week estrogen like action

Objective To study the relationship of proliferation and activation of T lymphocyte subsets and disease progression in antiretroviral-naive human immunodeficiency virus(HIV)-1-infected individuals.Methods Forty-nine antiretroviral-naive,chronically HIV-1 infected patients and 16 healthy,HIV-1 negative controls were enrolled in this study.The patients were divided into 3 groups according to their CD4+T cell counts:<200×106/L,(200-350)×106/L and>350×106/L.Peripheral blood mononuclear cells(PBMC)were isolated.T cell proliferation index was measured by Ki-67 staining.T cell activation was detected by CD38 staining.The samples were analyzed by flow cytometry.The data were compared by one-way ANOVA.Results The percentage of Ki-67+cells in CIM+T ceils was 7.92%±4.37%in CD4+T cell<200×106/L group,which was significantly higher than those 0.39%d:0.24%in control group,2.61%±2.12%in(200-350)×106/k group and 2.65%±2.13%in>350 X106/L group(F=21.961,P<0.01).The percentage of Ki-67+cells in CD8+T ceils in CD4+T cells<200×106/L group was 2.87%±1.13%,which was also much higher than those in other 3 groups(0.15%±0.90%,1.40%±1.17%,1.22%±0.80%,respectively F=19.203,P<0.01).The Ki-67'CD4'T cells and Ki-67+CD8+T cells were inversely correlated with CD4+T cell counts(r=-0.654,r=-0.539,respectively;P350×106/L group(F=14.333,F=15.412,respectively;P<0.01).The expressions of Ki-67+ on CD4+ and CD8+T cells were positively correlated with CD38 expression(r=0.527,r=0.391,respectively;P=0.002).Conclusions The proliferation and activation of T lymphoeytes are enhanced during HIV/AIDS disease progression.And T eell activation may be the result of persistent immune activation.

Objective To explore the effect of tea polyphenols on the growth of human papillomavirus 16 (HPV16) subgenes-immortalized human cervical epithelial cells (H8 cells).Methods Cultured H8 cells were divided into 5 groups to be treated with 0 (control group),6.25,12.5,25 and 50 mg/L tea polyphenols respectively for 24,36,and 48 hours,and then cell counting kit-8 (CCK8)assay was performed to detect cell proliferation.After 24 hours of incubation,flow cytometry was conducted to detect cell apoptosis and cell cycle,and fluorescence microscopy to observe the morphology of apoptotic cells.Results After incubation with tea polyphenols at different concentrations for 24,36 and 48 hours,the proliferation of H8 cells was inhibited,and 12.5 mg/L tea polyphenols could inhibit the relative growth rate of H8 cells in a time-dependent manner.Flow cytometry showed that there was a significant difference in cell apoptosis rate among the 6.25-,12.5-,25-,50-mg/L tea polyphenols groups and the control group (52.62％ ± 0.62％,52.22％ ± 0.72％,42.52％ ± 0.90％,45.96％ ± 2.11％,29.96％ ± 0.70％ respectively,F =272.0,P ＜ 0.05).Moreover,all the tea polyphenol groups showed significantly increased cell apoptosis rate compared with the control group (all P ＜ 0.05).Fluorescence microscopy showed karyopyknosis,nuclear fragmentation and other typical apoptotic morphological changes in H8 cells in tea polyphenols groups.There were significant differences in the percentage of cells in G1,G2 phase and cell proliferation index among the 5 groups (all P ＜ 0.05).Compared with the control group,the 6.25-,12.5-,25-mg/L tea polyphenols groups showed significantly increased percentage of cells in G1 phase (55.96％ ± 0.72％,54.12％ ± 3.20％,65.30％ ± 1.51％ respectively,all P ＜ 0.05),but significantly decreased percentage of cells in G2 phase (3.17 ± 1.82％,4.94 ± 1.46％,4.65 ± 4.26％ respectively,all P ＜ 0.05) and lower cell proliferation index(0.44 ± 0.01,0.46 ± 0.02,0.36 ± 0.01 respectively,all P ＜ 0.05).Conclusion Tea polyphenols can inhibit the proliferation of H8 cells,induce cell apoptosis,and block cell cycle progression.

Objective: To investigate the application of single-molecule PCR (SM-PCR) in the detection of plasma ctDNA for the treat-ment of patients with advanced lung adenocarcinoma. Methods: In total, 30 patients diagnosed with advanced lung adenocarcinoma were enrolled between June 2017 and May 2018. ctDNA fragments of the target genes (EGFR, KRAS, BRAF, ALK, HER2, and TP53) from the blood samples were enriched by SM-PCR, and DNA libraries were prepared. Finally, a high-throughput sequencing was performed. The EGFR detection of tumor tissue samples was performed using real-time fluorescence PCR based on the amplification refractory mutation system (ARMS) and consistency in the results of EGFR mutation detection in the plasma and tissue was compared. Results:The results of both the methods were consistent (Kappa=0.867, P<0.001). The McNemar's test also indicated that the results are not statistically different (P=0.500). Conclusions: SM-PCR can be used for the detection of plasma EGFR mutations. The target detection sites are more comprehensive and multiple mutations can be detected at the same time. Results of the analysis are more precise and can be absolutely quantified.

Malignant tumors， with the increasing crude morbidity and mortality year by year， have become the major diseases threatening human health. The conventional therapeutic drugs against tumors have serious adverse reactions， which can cause a heavy burden on patients. The active components of Chinese medicine can effectively inhibit tumor growth， improve the quality of life of patients， and have few toxic and side effects. Alkaloids of Chinese medicine are natural organic compounds widely existing in a variety of Chinese herbal medicines. In recent years， they have attracted more and more attention because of their anti-tumor effect. The anti-tumor mechanisms of alkaloids of Chinese medicine mainly include the induction of apoptosis， inhibition of tumor cell migration and invasion， suppression of proliferation， induction of autophagy of tumor cells， cell cycle arrest， inhibition of tumor angiogenesis， regulation of microRNA， and modulation of immunity. In addition， Chinese medicine alkaloids can also reverse tumor drug resistance and reduce the stemness of tumor stem cells. Alkaloids of Chinese medicine can regulate the phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， c-Jun N-terminal kinase （JNK）， p38 mitogen-activated protein kinase （p38 MAPK）， mammalian target of rapamycin （mTOR）， Notch， Hedgehog， Wnt/β-catenin， and other signaling pathways to participate in the processes of tumor proliferation， invasion and metastasis， autophagy and apoptosis， and affect the occurrence and development of tumors in multiple links and ways. The derivatives and nano-preparations of alkaloids can improve the solubility， utilization， and anti-tumor activity of alkaloids， bringing a broader prospect for the clinical application of alkaloids. This review summarized the recent anti-tumor research on alkaloids， their representative derivatives， and nano-preparations to provide references for the in-depth research on the anti-tumor effect of alkaloids.